The care of patients involved in serious car crashes and accidents will be confined to just two major centres in hospitals in Dublin and Cork under new health proposals.

Fears are growing that seriously injured patients in rural areas will end up with inferior emergency care if the Government opts for cut-price implementation of the plan.

'A Trauma System for Ireland' aims to improve survival rates, but will cost €57m in revenue and €28m in capital costs to roll out.

Under the scheme, Galway would have a lesser trauma unit "with specialised services" but no neurosurgical facilities.

In each of the two proposed networks, there would also be a number of other trauma units which would deal with less serious cases.

The expert group report follows a recent review which revealed that many are failing to receive the specialist care they need in A&Es around the country, putting their lives in jeopardy.

However, there was dismay last night after Health Minister Simon Harris said the long-awaited report would take seven years to implement.

The only funding so far for the report is to hire a clinical lead in the HSE to oversee trauma care and set up a new office.

Dr Emily O'Connor, spokeswoman for the country's A&E consultants, said emergency doctors warmly welcomed the report and pointed out that "for many years, we highlighted the urgent need to reform how trauma care is delivered to this small but very important subset of patients who sustain major life-threatening or life-changing injury.

"Good early care saves lives and ultimately saves money."

However, she said it was essential that past mistakes in the reorganisation of emergency services were not repeated.

The trauma centres need "massive investment to cope with the trauma coming into them", she added.

This will require hiring many more specialist staff in a range of areas and also ensuring staffing rosters can operate around the clock. "I would be concerned that implementation would happen without investment in pre-hospital services."

Crisis

Dr O'Connor added: "Local communities have to be confident that advanced paramedics that can come and collect them and bring them to major trauma centres.

"We must ensure we are not deserting major trauma patients in the periphery."

Dr O'Connor also said it was imperative that hospitals were given extra beds before the trauma plan was rolled out.

One of the designated centres, Cork University Hospital, is one of the worst hit by the trolley crisis.

Dr O'Connor said there are currently "daily heroics" under way in hospitals to give these patients the best possible care but the concentration of trauma care in a few centres has shown to be best way of improving survival.

Mr Harris said he would appoint a specialist this year to act as a National Clinical Lead for Trauma Services, to lead a new office for trauma services.

The specialist would "manage the implementation and oversight" of the trauma system.

Initial funding for this appointment is provided for in the 2018 budget.

"The current system is leading to poorer outcomes and preventable disability or death," he added.